国产抗纤溶药用前列腺电切术中对血小板保护作用的研究  

The efficacy of three domestic anti-fibrinolysis drugs on the protection of platelet in transurethrai resection of prostate patient.

作　　者：金红永 刘尔飞 闫国君 

机构地区：[1]黑龙江省立医院麻醉科,中国哈尔滨150036

出　　处：《中国麻醉与镇痛》2007年第1期1-2,共2页China Anesthesia and Analgesia

摘　　要：目的：探讨经尿道前列腺电切术中分别应用三种国产抗纤溶药——氨甲环酸、抑肽酶和止血芳酸对血小板的保护作用，以及对术后止血的功效．方法：选择60例良性前列腺增生手术患者，随机分为3组，即氨甲环酸组、抑肽酶组和止血芳酸组，测定术后12h，24h和48h的血小板计数、出血量、血浆纤溶酶活性和D-二聚体浓度。结果：术后血小板计数在氨甲环酸组和抑肽酶组相接近，在止血芳酸组则显着性下降。出血量在氨甲环酸组和抑肽酶组无显着性差异，在止血芳酸组显着性增高（P〈0．05）。血浆纤溶酶活性在氨甲环酸组和抑肽酶组显着性高于基础值，但仍有所降低；在止血芳酸组则显着性高于前二组。D-二聚体含量在三组间无显着性差异。结论．氨甲环酸和抑肽酶通过抑制纤溶亢进，均能确切减少前列腺电切术后的出血量，但抑肽酶存在潜在的过敏反应，且价格较贵，故以氨甲环酸更适宜於经尿道前腺电切术后止血。Objective To observe the efficacy of tranexamic acid,aprotinin or PAMBA on the antifibrinolytic treatment and the protection of platelet in transurethral resection of prostate （TURP）. Methods A series of sixty patients with benign prostatic hyperplasia were randomly divided into three groups as TA group, aprotinin group and PAMBA group. The platelet count, Plm activity, D-dimers and the bleeding volume were observed and recorded. Results The bleeding volume in TA group and aprotinin group were less than that of PAMBA group. The platelet count in TA group and aprotinin group was similar but was significantly lower in PAMBA group. Plm activity in TA group and aprotinin group was significantly higher than baseline value, but still had some reduction and was lower than that in PAMBA group. D-dimers Fhad no obvious change in all three groups. Conclusion The TA and aprotinin are more effective than PAMBA on the reducing of bleeding volume during TURP. The TA seems more suitable for the TURP＇patient because the approtinin has some adverse effects and its price is relative high.

关 键 词：经尿道前列腺电切术 氨甲环酸 抑肽酶 止血芳酸 血小板 

分 类 号：R697.3[医药卫生—泌尿科学]